European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
-
Eur J Cardiothorac Surg · Nov 2003
Cryoablation of the left posterior atrial wall: 95 patients and 3 years of mean follow-up.
Endocardial ablation of the left atrial posterior wall has been used to treat atrial fibrillation. Aim of the study was to evaluate its efficacy looking for the ablation pattern allowing a fast execution with limited interference on atrial contractility. Moreover a statistical analysis to identify predictors of long-term sinus rhythm recovery has been provided. ⋯ Permanent and persistent atrial fibrillation associated to a major cardiac disease can be safely treated with a linear ablation of the left atrial posterior wall. Satisfactory results in terms of rhythm restoration may be achieved regardless of the duration of the arrhythmia and its effects on atrial diameter. Any effort should be prompted to discharge patients in sinus rhythm. Life expectancy is longer if sinus rhythm is restored.
-
Overall mortality of the patients with a functional single ventricle is still high, though excellent mid- and long-term results of the modified Fontan procedure have been reported. This study assessed the factors that affect the surgical outcomes mainly in the pre-Fontan stage and performed long-term survival analysis. ⋯ This study revealed that the overall survival was disappointing and there were still problems that need to be solved in the pre-Fontan stage to improve the overall survival. The role of BCPS was not to contribute to the longer survival after Fontan operation, but to lower mortality in the pre-Fontan stage, which can offer a higher probability to proceed to the Fontan procedure successfully.
-
To assess the outcome of pulmonary resection in the management of massive hemoptysis caused by benign lung diseases. ⋯ Immediate pulmonary resection for massive hemoptysis is effective in case of life-threatening bleeding that is not controlled by conservative measures. Elderly patients with a prior history of hemoptysis and/or hypertension and bleeding due to a fungus ball, necrotizing pneumonia, tuberculosis or lung abscess should be considered for early operation in an attempt to reduce morbidity and mortality.
-
Eur J Cardiothorac Surg · Nov 2003
Outcome prediction in coronary artery bypass grafting and valve surgery in the Netherlands: development of the Amphiascore and its comparison with the Euroscore.
(1) To define models that predict in-hospital death, major adverse cardiac events and extended intensive care unit duration for patients who underwent coronary artery bypass grafting (CABG), a heart valve operation or combined; and (2) to validate the Euroscore model in our population. ⋯ The Amphia score performs as well as the Euroscore in discriminating patients with respect to in-hospital death. Our models for predicting major adverse cardiac events and extended length of stay on intensive care may be useful tools in categorising patients in various subgroups of risk for postoperative morbidity.
-
Eur J Cardiothorac Surg · Nov 2003
Impact of hypothermic selective cerebral perfusion compared with hypothermic cardiopulmonary bypass on cerebral hemodynamics and metabolism.
Hypothermic selective cerebral perfusion (SCP) is widely used for cerebral protection during aortic arch surgery, but the effect of the absence of systemic perfusion on cerebrovascular dynamics it has never been established. This study explored the physiology of prolonged SCP compared to hypothermic cardiopulmonary bypass (HCPB) in pigs. ⋯ We conclude that, compared with HCPB, SCP results in beneficial cerebral vasodilatation, as evidenced by significantly higher CBF and oxygen consumption during SCP, by prompt recovery of oxygen consumption after rewarming, and by significantly lower ICP during perfusion and in the post-bypass period.